The optimal home blood pressure monitoring schedule based on the Didima outcome study
Abstract
This study investigated the optimal schedule for home blood pressure (HBP) monitoring that has the greatest prognostic ability and provides the most reliable assessment of HBP. The Didima study assessed the value of HBP (duplicate morning and evening measurements, 3 days) in predicting cardiovascular events in the general population (662 adults, 8.2+/-0.2 years follow-up). Criteria for the optimal monitoring schedule were stabilization of mean HBP, its variability (standard deviation (s.d.)) and hazard ratios (HRs) of cardiovascular events per 1 mm Hg HBP increase. By averaging more readings (1-12), there was a progressive decline in average HBP and its s.d. and increase in HR, with most of these benefits achieved on the second day (8 readings) and little additional benefit obtained on the third day (12 readings). The first day gave higher and more unstable HBP values (higher s.d.) with less prognostic ability (lower HR). The first HBP readings per occasion gave higher values but with similar prognostic ability as the second readings taken 1 min later. There was little difference in average HBP between morning and evening readings with no prognostic superiority of morning readings. In conclusion, by averaging more readings the average HBP and its variability are reduced and the prognostic ability improved. Any aspect of HBP monitoring (first or second readings, morning or evening) has similar prognostic ability. The first day gives higher and unstable values with lower prognostic ability and should be better discarded. These data validate the HBP monitoring schedule proposed by the European Society of Hypertension.
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A Finnish study showed that HBP was lower on the weekend than on workdays.
“A Finnish study showed that HBP was lower on the weekend than on workdays [134]”
Cites
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Self-citationSTERGIOU, G., SALGAMI, E., TZAMOURANIS, D., & ROUSSIAS, L. (2005) · American Journal of Hypertension · doi:10.1016/j.amjhyper.2005.01.003 · Cited by 157 · see citing works
Self-citationHome Self Blood Pressure Measurement in General Practice The SMART Study
Chatellier, G. (1996) · American Journal of Hypertension · doi:10.1016/0895-7061(96)00018-0 · Cited by 116 · see citing works
Home Blood Pressure Monitoring in Children: How Many Measurements are Needed?
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Measurement of Blood Pressure in Humans: A Scientific Statement From the American Heart Association
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Self-citationOutcome-Driven Thresholds for Increased Home Blood Pressure Variability
Juhanoja, E. P., Niiranen, T. J., Johansson, J. K., Puukka, P. J., Thijs, L., Asayama, K., Langén, V. L., Hozawa, A., Aparicio, L. S., Ohkubo, T., et al. (2017) · Hypertension · doi:10.1161/hypertensionaha.116.08603 · Cited by 83 · see citing works
Self-citationBello, N. A., Schwartz, J. E., Kronish, I. M., Oparil, S., Anstey, D. E., Wei, Y., Cheung, Y. K. K., Muntner, P., & Shimbo, D. (2018) · Journal of the American Heart Association · doi:10.1161/jaha.118.008658 · Cited by 42 · see citing works
The optimal schedule for self-home blood pressure monitoring
Stergiou, G. S., & Ntineri, A. (2015) · Journal of Hypertension · doi:10.1097/hjh.0000000000000509 · Cited by 22 · see citing works
Self-citationHome Blood Pressure Monitoring Schedule
Niiranen, T. J., McManus, R. J., Ohkubo, T., & Stergiou, G. S. (2020) · Updates in Hypertension and Cardiovascular Protection · doi:10.1007/978-3-030-23065-4_6 · Cited by 1 · see citing works
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- Authors
- Stergiou, G. S., Nasothimiou, E. G., Kalogeropoulos, P. G., Pantazis, N., & Baibas, N. M.
- Affiliations
- National and Kapodistrian University of Athens (GR)
- Corresponding author
- Stergiou, G S
- Venue
- Journal of Human Hypertension
- Published
- 2009-07-09
- Volume
- 24
- Issue
- 3
- Pages
- 158-164
- ISSN
- 0950-9240 (ISSN-L)
- 1476-5527
- OpenAlex
- W2020200519
- Cited by
- 56
- References
- 6
- Citations by year
- 2026: 4 · 2025: 3 · 2023: 3 · 2022: 5 · 2021: 2 · 2020: 2 · 2019: 7 · 2018: 5 · 2017: 2 · 2016: 3 · 2015: 4 · 2014: 5 · 2013: 3 · 2012: 5
- FWCI
- 1.64
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Human Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Keywords
- home blood pressure monitoring, cardiovascular events, blood pressure variability, prognostic value, European Society of Hypertension guidelines
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Circadian Rhythm, Female, Follow-Up Studies, Humans, Hypertension, Male, Middle Aged, Predictive Value of Tests, Prognosis, Risk Factors, Reproducibility of Results, Proportional Hazards Models, Blood Pressure Monitoring, Ambulatory, Young Adult
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